Clinical and Genetic Characteristics of Antiplatelet Therapy Resistance After Ischemic Stroke (Literature Review)

Every year, 20 % of all ischemic strokes are recurrent, characterized by severe course and high mortality and disability rates. Secondary prevention measures are aimed at preventing repeated brain catastrophes, which leads to a 20–30 % reduction in the risk of recurrent stroke. One of the directions of therapy is the appointment of antiplatelet drugs. Currently, acetylsalicylic acid and clopidogrel are widely used in the Russia. Effective platelet inhibition by prescribing these antiplatelet agents is one of the priorities in the treatment of atherothrombotic ischemic stroke. At the same time, a number of patients develop resistance to antiplatelet agents, which is associated with a variety of factors, such as drug interactions, concomitant diseases, and genetic predisposition. In order to control the formation of laboratory resistance, several methods for assessing platelet function have been developed. For example, optical Born aggregatometry, thromboelastogram, flow cytometry. Currently, there is no “golden method” for determining the high residual activity of platelets, since none of them has achieved a significant advantage. This article discusses methods for detecting laboratory resistance and factors influencing its development, depending on the prescribed antiplatelet drug.